Healthcare Provider Details

I. General information

NPI: 1609938984
Provider Name (Legal Business Name): FLAURYSE M BAGUIDY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 HWY 281 SOUTH USPHS IHS WATONGA HEALTH CENTER
WATONGA OK
73772
US

IV. Provider business mailing address

817 PARK AVE
WATONGA OK
73772
US

V. Phone/Fax

Practice location:
  • Phone: 580-623-4994
  • Fax: 580-623-5490
Mailing address:
  • Phone: 580-623-9968
  • Fax: 485-227-9968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: